Effective response of nonlinear composite under external AC and DC electric field

A perturbation method is used to study effective response of nonlinear Kerr composites, which are subject to the constitutive relation of electric displacement and electric field, D-alpha = epsilon(alpha)E + chi(alpha)vertical bar E vertical bar(2)E. Under the external AC and DC electric field E-app = E-a (1 + sinwt), the effective nonlinear responses and local potentials are induced by the cubic nonlinearity of Kerr materials at all harmonics. As an example in three dimensions, we have investigated this kind of nonlinear composites with spherical inclusions embedded in a host. At all harmonic frequencies, the potentials in inclusion and host regions are derived. Furthermore, the formulae of the effective linear and nonlinear responses are given in the dilute limit.

Controlling electric field distribution by graded spherical core-shell metamaterials

This paper investigates analytically the electric field distribution of graded spherical core-shell metamaterials, whose permittivity is given by the graded Drude model. Under the illumination of a uniform incident optical field, the obtained results show that the electrical field distribution in the shell region is controllable and the electric field peak's position inside the spherical shell can be confined in a desired position by varying the frequency of the optical field as well as the parameters of the graded dielectric profiles. It has also offered an intuitive explanation for controlling the local electric field by graded metamaterials.

Localization of the electric-field distribution in graded core-shell metamaterials

The local electric-field distribution has been investigated in a core-shell cylindrical metamaterial structure under the illumination of a uniform incident optical field. The structure consists of a homogeneous dielectric core, a shell of graded metal-dielectric metamaterial, embedded in a uniform matrix. In the quasistatic limit, the permittivity of the metamaterial is given by the graded Drude model. The local electric potentials and hence the electric fields have been derived exactly and analytically in terms of hypergeometric functions. Our results showed that the peak of the electric field inside the cylindrical shell can be confined in a desired position by varying the frequency of the optical field and the parameters of the graded profiles. Thus, by fabricating graded metamaterials, it is possible to control electric-field distribution spatially. We offer an intuitive explanation for the gradation-controlled electric-field distribution.

Effective dielectric response of nonlinear composites with external ac and dc electric field

The perturbation method is developed to investigate the effective nonlinear dielectric response of Kerr composites when the external ac and dc electric field is applied. Under the external ac and dc electric field E-app=E-a(1+sin omegat), the effective coupling nonlinear response can be induced by the cubic nonlinearity of Kerr nonlinear materials at the zero frequency, the finite basic frequency omega, the second and the third harmonics, 2omega and 3omega, and so on. As an example, we have investigated the cylindrical inclusions randomly embedded in a host and derived the formulas of the effective nonlinear dielectric response at harmonics in dilute limit. For a higher concentration of inclusions, we have proposed a nonlinear effective-medium approximation by introducing the general effective nonlinear response. With the relationships between the effective nonlinear response at harmonics and the general effective nonlinear response, we have derived a set of formulas of the effective nonlinear dielectric responses at harmonics for a larger volume fraction. (C) 2004 American Institute of Physics.

Higher order response of nonlinear composite in external AC electric field

The fifth-order effective nonlinear responses at fundament frequency and higher-order harmonics are given for nonlinear composites, which obey a current-field relation of the form J = sigmaE + x\E\(2) E, if a sinusoidal alternating current (AC) external field with finite frequency omega is applied. As two examples, we have investigated the cylinder and spherical inclusion embedded in a host and, for larger volume fraction, also derived the formulae of effective nonlinear responses at higher-order harmonics by the aid of the general effective response definition. Furthermore, the relationships between effective nonlinear responses at harmonics are given. (C) 2003 Elsevier Science B.V. All rights reserved.

Effective response of a non-linear composite in external AC electric field

A general effective response is proposed for nonlinear composite media, which obey a current field relation of the form J = sigmaE + chi\E\(2) E when an external alternating current (AC) electrical field is applied. For a sinusoidal applied field with finite frequency omega, the effective constitutive relation between the current density and electric field can be defined as, = sigma(e) + chi(e) <\E(x, omega, t)\(2) E(x, omega, t)> + (. . .), where sigma(e) and chi(e) are the general effective linear and nonlinear conductive responses, respectively. The angled brackets <(. . .)> denotes the ensemble average. As two examples, we have investigated the cylindrical and spherical inclusions embedded in a host and also derived the formulae of the general effective linear and nonlinear conductive responses in dilute limit. For higher volume fraction of inclusions, we have proposed a nonlinear effective medium approximation (EMA) method to estimate the general effective response of nonlinear composites in external AC field. Furthermore, the effective nonlinear responses at harmonics are predicted by using the general effective response. (C) 2002 Elsevier Science B.V. All rights reserved.

Protein A tangential flow affinity membrane cartridge for extracorporeal immunoadsorption therapy

Tangential flow affinity membrane cartridge (TFAMC) fs a new model of immunoadsorption therapy for hemoperfusion. Recombinant Protein A was immobilized on the membrane cartridge through Schiff base formation for extracorporeal IgG and immune complex removal from blood. Flow characteristics, immunoadsorption capacity and biocompatibility of protein A TFAMC were studied. The results showed that the pressure drop increased with the increasing flow rate of water, plasma and blood, demonstrating reliable strength of membrane at high now rare. The adsorption capacities of protein A TFAMC for IgG from human plasma and blood were measured. The cartridge with 139 mg protein A immobilized on the matrix (6 mg protein A/g dry matrix) adsorbed 553 mg IgG (23.8 mg IgG/g dry matrix) from human plasma and 499.4 mg IgG (21.5 mg IgG/g dry matrix) from human blood, respectively. The circulation time had a major influence on IgG adsorption capacity, but the flow rate had little influence. Experiments in vitro and in vivo confirmed that protein A TFAMC mainly adsorbed Ige and Little of other plasma proteins, and that blood cell damage was negligible. The extracorporeal circulation system is safe and reliable. Copyright (C) 1999 John Wiley & Sons, Ltd.

Low-level laser therapy and light-emitting diode effects in the secretion of neuropeptides SP and CGRP in rat skin

The phototherapy effects in the skin are related to biomodulation, usually to accelerate wound healing. However, there is no direct proof of the interrelation between the effects of low-level laser therapy (LLLT) and light-emitting diode (LED) in neuropeptide secretion, these substances being prematurely involved in the neurogenic inflammation phase of wound healing. This study therefore focused on investigating LLLT and LED in Calcitonin gene-related peptide (CGRP) and substance P (SP) secretion in healthy rat skin. Forty rats were randomly distributed into five groups with eight rats each: Control Group, Blue LED Group (470 nm, 350 mW power), Red LED Group (660 nm, 350 mW power), Red Laser Group (660 nm, 100 mW power), and Infrared Laser Group (808 nm, 100 mW power) (DMCA (R) Equipamentos Ltda., So Carlos, So Paulo, Brazil). the skin of the animals in the experimental groups was irradiated using the punctual contact technique, with a total energy of 40 J, single dose, standardized at one point in the dorsal region. After 14 min of irradiation, the skin samples were collected for CGRP and SP quantification using western blot analysis. SP was released in Infrared Laser Group (p = 0.01); there was no difference in the CGRP secretion among groups. Infrared (808 nm) LLLT enhances neuropeptide SP secretion in healthy rat skin.

Ototoxicity evaluation in medulloblastoma patients treated with involved field boost using intensity-modulated radiation therapy (IMRT): a retrospective review

Background: Ototoxicity is a known side effect of combined radiation therapy and cisplatin chemotherapy for the treatment of medulloblastoma. the delivery of an involved field boost by intensity modulated radiation therapy (IMRT) may reduce the dose to the inner ear when compared with conventional radiotherapy. the dose of cisplatin may also affect the risk of ototoxicity. A retrospective study was performed to evaluate the impact of involved field boost using IMRT and cisplatin dose on the rate of ototoxicity.Methods: Data from 41 medulloblastoma patients treated with IMRT were collected. Overall and disease-free survival rates were calculated by Kaplan-Meier method Hearing function was graded according to toxicity criteria of Pediatric Oncology Group (POG). Doses to inner ear and total cisplatin dose were correlated with hearing function by univariate and multivariate data analysis.Results: After a mean follow-up of 44 months (range: 14 to 72 months), 37 patients remained alive, with two recurrences, both in spine with CSF involvement, resulting in a disease free-survival and overall survival of 85.2% and 90.2%, respectively. Seven patients (17%) experienced POG Grade 3 or 4 toxicity. Cisplatin dose was a significant factor for hearing loss in univariate analysis (p < 0.03). in multivariate analysis, median dose to inner ear was significantly associated with hearing loss (p < 0.01). POG grade 3 and 4 toxicity were uncommon with median doses to the inner ear bellow 42 Gy (p < 0.05) and total cisplatin dose of less than 375 mg/m(2) (p < 0.01).Conclusions: IMRT leads to a low rate of severe ototoxicity. Median radiation dose to auditory apparatus should be kept below 42 Gy. Cisplatin doses should not exceed 375 mg/m(2).

‘It was almost like the opposite of what I needed’: a qualitative exploration of client experiences of unhelpful therapy

Background: The issue of unhelpful and harmful therapy outcome has received an increasing amount of attention within the research literature in recent years. However, little research exists on the client's perspective of what constitutes unhelpful therapy. Aim: The aim of this study was to explore clients’ experiences of unhelpful therapy. Method: Semi-structured interviews were carried out with ten therapists who, as clients, experienced unhelpful therapy. Interview transcripts were analysed using interpretative phenomenological analysis. Findings: Participants recounted therapy episodes characterised by an absence of negotiation, collaboration and care; pivotal moments when they knew that they would not return; and ongoing negative effects. Conclusions: The findings of this study have implications for training and strategies for supporting clients who have been harmed by therapy.

Síndrome Dolorosa Miofascial no contexto da Medicina Dentária

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review

Paper published in PLoS Medicine in 2007.

Rationing Antiretroviral Therapy for HIV/AIDS in Africa: Efficiency, Equity, and Reality

Background: Rationing of access to antiretroviral therapy already exists in sub-Saharan Africa and will intensify as national treatment programs develop. The number of people who are medically eligible for therapy will far exceed the human, infrastructural, and financial resources available, making rationing of public treatment services inevitable. Methods: We identified 15 criteria by which antiretroviral therapy could be rationed in African countries and analyzed the resulting rationing systems across 5 domains: clinical effectiveness, implementation feasibility, cost, economic efficiency, and social equity. Findings: Rationing can be explicit or implicit. Access to treatment can be explicitly targeted to priority subpopulations such as mothers of newborns, skilled workers, students, or poor people. Explicit conditions can also be set that cause differential access, such as residence in a designated geographic area, co-payment, access to testing, or a demonstrated commitment to adhere to therapy. Implicit rationing on the basis of first-come, first-served or queuing will arise when no explicit system is enforced; implicit systems almost always allow a high degree of queue-jumping by the elite. There is a direct tradeoff between economic efficiency and social equity. Interpretation: Rationing is inevitable in most countries for some period of time. Without deliberate social policy decisions, implicit rationing systems that are neither efficient nor equitable will prevail. Governments that make deliberate choices, and then explain and defend those choices to their constituencies, are more likely to achieve a socially desirable outcome from the large investments now being made than are those that allow queuing and queue-jumping to dominate.

How Much Does It Cost to Provide Antiretroviral Therapy for HIV/AIDS in Africa?

Background: Many African countries are rapidly expanding HIV/AIDS treatment programs. Empirical information on the cost of delivering antiretroviral therapy (ART) for HIV/AIDS is needed for program planning and budgeting. Methods: We searched published and gray sources for estimates of the cost of providing ART in service delivery (non-research) settings in sub-Saharan Africa. Estimates were included if they were based on primary local data for input prices. Results: 17 eligible cost estimates were found. Of these, 10 were from South Africa. The cost per patient per year ranged from $396 to $2,761. It averaged approximately $850/patient/year in countries outside South Africa and $1,700/patient/year in South Africa. The most recent estimates for South Africa averaged $1,200/patient/year. Specific cost items included in the average cost per patient per year varied, making comparison across studies problematic. All estimates included the cost of antiretroviral drugs and laboratory tests, but many excluded the cost of inpatient care, treatment of opportunistic infections, and/or clinic infrastructure. Antiretroviral drugs comprised an average of one third of the cost of treatment in South Africa and one half to three quarters of the cost in other countries. Conclusions: There is very little empirical information available about the cost of providing antiretroviral therapy in non-research settings in Africa. Methods for estimating costs are inconsistent, and many estimates combine data drawn from disparate sources. Cost analysis should become a routine part of operational research on the treatment rollout in Africa.

Non-clinical outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review

The impacts of antiretroviral therapy on quality of life, mental health, labor productivity, and economic wellbeing for people living with HIV/AIDS in developing countries are only beginning to be measured. We conducted a systematic literature review to analyze the effect of antiretroviral therapy (ART) on these non-clinical indicators in developing countries and assess the state of research on these topics. Both qualitative and quantitative studies were included, as were peer-reviewed articles, gray literature, and conference abstracts and presentations. Findings are reported from 12 full-length articles, 7 abstracts, and 1 presentation (representing 16 studies). Compared to HIV-positive patients not yet on treatment, patients on ART reported significant improvements in physical, emotional and mental health and daily function. Work performance improved and absenteeism decreased, with the most dramatic changes occurring in the first three months of treatment and then leveling off. Little research has been done on the impact of ART on household wellbeing, with modest changes in child and family wellbeing within households where adults are receiving ART reported so far. Studies from developing countries have not yet assessed non-clinical outcomes of therapy beyond the first year; therefore, longitudinal outcomes are still unknown. As ART roll out extends throughout high HIV prevalence, low-resource countries and is sustained over years and decades, both positive and adverse non-clinical outcomes need to be empirically measured and qualitatively explored in order to support patient adherence and maximize treatment benefits.